• 제목/요약/키워드: 과잉행동장애

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주의력결핍-과잉행동장애의 신경발달학적 고찰 (NEURODEVELOPMENTAL PERSPECTIVE OF ATTENTION-DEFICIT/HYPERACTIVITY DISORDER(ADHD))

  • 안동현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제16권2호
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    • pp.160-172
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    • 2005
  • ADHD는 소아정신질환 가운데 가장 흔한 신경발달학적 질환으로 간주되고 있다. ADHD의 원인은 아직 명확하게 밝혀지지는 않았지만 다양한 유전적 및 신경학적 요인들이 관여하는 것은 틀림없고, 이들이 신경계의 특정 부위와 경로에 이상을 초래하는 것으로 알려져 있다. 이 논문에서는 최근의 연구들을 중심으로 ADHD의 원인과 관련한 신경발달학적 측면을 고찰하고자 한다. 방법은 Medline검색을 통해 최근 발표된 논문들, ADHD관련 단행본, ADHD를 특집으로 한 몇 개의 잡지에 실린 종설 논문들 및 연관 참고문헌 등을 토대로 조사하였다. 결과는 ADHD의 신경발달학적 측면에서 일부 유전적인 요인과 임신 및 출생전후의 환경적 요인 등이 복합적으로 작용하여 발달하는 뇌를 변형시킴으로서 주로 대뇌의 prefrontal cortex-striatal network를 구조적으로 혹은 기능적으로 저하되어 발생하는 것으로 생각할 수 있다. 임신 2기에 ADHD의 발생과 관련한 대뇌 및 소뇌 이상을 초래한다는 주장을 하기도 하였으며, 이들 이상은 더 이상 진행하지 않고 고정된 것이라는 주장도 있지만, ADHD의 원인과 관련하여 신경발달학적으로 어떤 시기에, 어떤 손상이나 영향에 의해, 어떤 이상이 초래하여 발생하는지에 대해서는 아직 연구가 매우 부족하다. 결론적으로 주의력 체계와 관련한 신경전달회로의 차이, 도파민계와 노에피네프린계의 기능이나 증상과 관련한 차이 등 을 포함하여 신경발달학적인 면에 대한 보다 심도 있는 연구들이 시행되어야 할 것이다.

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주의력결핍 과잉행동장애 부모에서 MMPI 특성 (MMPI Characteristics of Parents of Children with ADHD)

  • 김민권;홍종우;임명호;도진아;오은영;이경규;백기청
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권3호
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    • pp.149-155
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    • 2011
  • Objectives: The current study investigated the personality characteristics of parents of children with attention-deficit hyperactivity disorder (ADHD) using the Minnesota Multiphasic Personality Inventory (MMPI), which is commonly used in clinical medicine. Methods: Participants were 117 parents of children with ADHD (96 boys and 21 girls) and 77 parents of comparison children (50 boys and 27 girls), who completed the Korean version of the MMPI. Results: The MMPI scores of the fathers of ADHD children were significantly higher on the Psychopathic Deviate (Pd), Masculinity-Femininity (Mf), Paranoia (Pa), and Psychasthenia (Pt) scales than the comparison group's were. In addition, the mothers of ADHD children had higher MMPI scores on the traits of Hypochondriasis (Hs), Psychopathic Deviate (Pd), and Schizophrenia (Sc) than the comparisong roup had, but were not significantly higher. Conclusion: The fathers of ADHD children might be antisocial, irresolute, passive, paranoid, and anxious. In addition, mothers of ADHD children might have hypochondriacal, antisocial, and/or psychological confusional traits, but these were not be significantly high. These results suggest that the psychopathology of parents of ADHD children might correlate with their children's ADHD.

약물치료 중인 주의력결핍 과잉행동장애 아동 청소년에서 작업기억력 훈련이 임상증상과 신경심리소견에 미치는 부가적 효과 (Augmentative Effects of Working Memory Training on Clinical Symptoms and Neuropsychology in Medicated Children and Adolescents with Attention-Deficit Hyperactivity Disorder)

  • 김혜선;이은경;홍인화;안정숙;유한익
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.123-131
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    • 2017
  • Objectives: Executive dysfunction including working memory deficit has been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of Cogmed working memory training on the symptoms and neurocognitive functions in medicated children and adolescents with ADHD. Methods: Twenty-five children with ADHD, aged 7 to 19 years, taking ADHD medication participated in this study. The participants were trained for 5 weeks with a commercially available and computerized working memory program ($Cogmed^{(R)}$) without any changes to their medication. The Korean version of the ADHD Rating Scale, Clinical Global Impression Scale, and Comprehensive Attention Test were administered before training and 4 weeks and 7 months after training, respectively. Results: After completing the training, the clinical symptoms and function, rated by the parents and clinician, were improved. In addition, the level of commission errors was significantly reduced in the selective attention (visual/auditory) task, sustained attention to response task, and flanker task. The untrained visuospatial short-term memory and working memory were also improved. These effects were still observed 7 months after the training. Conclusion: Cogmed working memory training can be a promising training option for the additional improvement of the symptoms and deficits in working memory and response inhibition in medicated children with ADHD.

주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(III) - 약물치료 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (III) - Pharmacological Treatment -)

  • 김효원;김은주;김지훈;박장호;반건호;이연정;정경운;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.70-83
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    • 2017
  • The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

주의력결핍 과잉행동장애 한국형 치료 권고안(IV) - 비약물적 치료 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (IV) - Non-Pharmacologic Treatment -)

  • 신윤미;김의정;김윤신;방수영;이은하;이철순;장형윤;홍민하;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.84-95
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder that begins in early childhood and can persist throughout adulthood. ADHD causes difficulties in various area of life, such as academic achievement, peer relationships, family functioning, employment and marriage. Although ADHD is known to respond well to medication, such treatment is more effective when combined with psychosocial (non-pharmacologic) therapy in terms of alleviating the core symptoms and improving appropriate functions. Psychosocial treatment interventions are divided into psychoeducation, behavioral parent training, school intervention, cognitive behavior therapy, social skill training, parent-child interaction therapy, play therapy, other treatments (coaching, complementary and alternative medicine), neurofeedback and Cogmed. Adult ADHD cognitive behavioral therapy is described separately. These practice parameters summarize the evidence for psychosocial treatment. Based on this evidence, specific recommendations are provided for psychosocial interventions.

주의력결핍 과잉행동장애 아동에서 감정인식능력 및 충동성이 공격성에 미치는 영향 (The Effect of Impulsivity and the Ability to Recognize Facial Emotion on the Aggressiveness of Children with Attention-Deficit Hyperactivity Disorder)

  • 배승민;신동원;이수정
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제20권1호
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    • pp.17-22
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    • 2009
  • Objectives : A higher level of aggression has been reported for children with attention-deficit/hyperactivity disorder (ADHD) than for non-ADHD children. Aggression was shown to have a negative effect on the social functioning of children with ADHD. The ability to recognize facial emotion expression has also been related to aggression. In this study, we examined whether impulsivity and dysfunctional recognition of facial emotion expression could explain the aggressiveness of children with ADHD. Methods : 67 children with ADHD participated in this study. We measured the ability to recognize facial emotion expression by using the Emotion Recognition Test (ERT) and we measured aggression by the T score of the aggression subscale of the Child Behavior Checklist (CBCL). Impulsivity was measured by the ADHD diagnostic system (ADS). Results : The teacher rated level of aggression was related to the score of recognizing negative affect. After controlling for the effect of impulsivity, this relationship is not significant. Only the score of the visual commission errors ex plained the level of aggression of children with ADHD. Conclusion : Impulsivity seems to have a major role in explaining the aggression of children with ADHD. The clinical implication of this study is that effective intervention for controlling impulsivity may be expected to reduce the aggression of children with ADHD.

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교사의 내·외통제성과 지도성 유형이 학령기 주의력결핍 과잉행동장애 학생의 교육적 중재에 미치는 영향 (Effects of teachers' internal-external control and leadership type on educational intervention for School-aged Attention Deficit Hyperactivity Disorder)

  • 조영경;박완주
    • 한국간호교육학회지
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    • 제20권3호
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    • pp.382-391
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    • 2014
  • Purpose: The purpose of this study was to identify the predictors influencing on educational intervention for Attention Deficit Hyperactivity Disorder (ADHD) after analyzing the relationship among teachers' internal-external locus of control, leadership type and educational intervention for ADHD. Methods: A cross sectional study design was conducted with 255 teachers in three schools located in D, K and Y city. The data were analyzed by t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression using SPSS 20.0. Results: Internal locus of control showed significantly positive correlations with educational intervention for ADHD. Efficient leadership type, harmony-oriented leadership type showed significant differences in inefficient leadership type on educational intervention for ADHD. Significant factors of the educational intervention were efficient leadership type, harmony-oriented leadership type, task-oriented leadership type and internal locus of control that were explained by 20.0% (F=12.5, p<.001) of educational intervention for ADHD. Conclusion: Based on the findings of this study, it is necessary to have teacher's efficient leadership type focused on ADHD symptoms. Teachers need to enhance their positive domain of internal-external locus of control towards students with ADHD to increase the effectiveness of their educational interventions for ADHD.

주의력 결핍 과잉행동장애 아동에서 어머니의 상태불안이 아동의 신체증상에 미치는 영향 (The Effect of Maternal State Anxiety on the Children's Somatic Symptom in Attention-Deficit/Hyperactivity Disorder)

  • 김경미;신동원;이근문
    • 생물정신의학
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    • 제14권4호
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    • pp.256-261
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    • 2007
  • Objectives : The aim of the present study was to examine whether anxiety and depression of children and mothers were associated with the children's medically unexplained somatic symptoms in attention-deficit/hyperactivity disorder(ADHD). Methods : 83 clinic-referred boys with ADHD and 52 boys without ADHD were included in this study. The frequency of the medically unexplained somatic symptoms, such as general-ache, headache, nausea, eye problems, skin problems, abdominal pain, vomiting was evaluated using the somatic symptom domain of the Child Behavior Checklist(CBCL). Children's anxiety and depression were evaluated using Kovacs Children's Depression Inventory(CDI) and Spielberger's State-Trait Anxiety Inventory(STAI) for children. Maternal anxiety and depression were measured by Spielberger's State-Trait Anxiety Inventory(STAI) and Beck's Depression Inventory(BDI). Stepwise linear regression analysis was used to examine the hypothesis. Results : Score of maternal state anxiety affects the T score of the somatic symptom domain in CBCL significantly(adjusted $R^2$=0.057 ; p=0.026). Conclusion : The frequency of medically unexplained somatic symptom of children perceived by mothers was associated with the high level of maternal state anxiety in ADHD. Frequent maternal report of the children's somatic symptom may be a warrant for the evaluation and management of the maternal state anxiety in ADHD.

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주의력결핍 과잉행동장애, 과거에도 있었을까? - 역사적 고찰을 중심으로 - (ADHD, New Developed or Newly Found : Historical Review)

  • 반건호;배재호;문수진;민정원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권2호
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    • pp.57-66
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    • 2011
  • Introduction : Attention-deficit hyperactivity disorder (ADHD) was a newly coined term for a disease that existed prior to its naming in the mid 20th century. The issue about whether ADHD is a new disorder or merely a new name for an existing disorder is still controversial. The authors tried to find the clues to the answer for this question through reviewing historical documents for traces of ADHD. Contents : We could find literatures and medical records that contain possible ADHD symptoms. In particular, in 1845, Heinrich Hoffmann's 'fidgety Philip' or 'Johnny Look-in-the-air' nearly satisfies today's criteria for ADHD. Methylphenidate was approved as a promising chemical for inattention in 1957 before the establishment of the concept of ADHD. In 1968, ADHD was first officially introduced as "Hyperactivity Reaction of Childhood" by DSM-II. In 1980, DSM-III, 'Attention Deficit Disorder (ADD)' was adopted as an official diagnostic term and changed to 'ADHD' since the creation of DSM-III-R in 1987. Conclusion : As stated above, ADHD has existed since long ago and became familiar via an advanced diagnostic system and therapeutic options.